[Bone defect adjusted strategy in revision arthroplasty of the hip : Wich implant in wich situation? Innovations and approved methods]. / Defektadaptierte Rekonstruktionsstrategien in der Hüftrevisionsendoprothetik : Welches Implantat in welcher Situation? Innovationen und Bewährtes.

BACKGROUND: Revision total hip arthroplasty is of rising importance, with 35,000 procedures a year in Germany. OBJECTIVES: Primary stability of the revision implant, reconstruction of the anatomical hip center, reconstruction of bone stock, and permanent secondary integration are the main priorities. METHODS: Current literature and examples from our own experience are presented. RESULTS AND CONCLUSIONS: Novel developments from basic research and industrial partners extend the possibilities for treating affected patients. For an integrated therapy concept in implant selection criteria, such as situation and structure of the defect, combination with any remaining implants, causes of loosening and failure, implant allergy, and patient-specific parameters should be taken into consideration.

[Influence of intraoperative noise protection on postoperative pain: demonstrated exemplified by total knee arthroplasty]. / Einfluss der intraoperativen Schallprotektion auf postoperative Schmerzen : Dargestellt am Beispiel der Knieendoprothetik.

BACKGROUND: It is known that implied memory of intraoperative noise influences postoperative pain. The aim of this study was to evaluate the influence of different intraoperative noise protection methods during total knee arthroplasty on postoperative pain scores. MATERIAL AND METHODS: A total of 83 patients were included in this prospectively designed, double-blind trial and underwent total knee arthroplasty with psoas compartment and sciatic nerve regional anesthesia and additionally propofol sedation. After randomization patients were assigned either to the noise protection group, the music group or the control group. Postoperative pain scores (VAS) were evaluated in each group. RESULTS: In the three different time intervals evaluated there were no significant differences between the groups. Also the pain maxima for each postoperative day showed no significant difference but there was a slight trend to the advantage of the music group. CONCLUSION: Even though there were no significant effects of music or noise protection on postoperative pain scores, it can be concluded, as has been done by many other authors that music should be used in the perioperative setting for general patient comfort.